Marijuana -- when is it useful, what's the downside? Maybe you're like a lot of Americans and have never used it, recreationally or medically. Or perhaps you have. Either way, our social standards about this controversial drug are shifting. It's legally available for medicinal use, here and now.

There is very strong evidence that medical cannabis can help with certain chronic conditions and provide relief for many people with chronic pain. There is also a fairly long list of unwelcome side-effects. If you are considering this drug, let's agree that it's worthwhile to review, with your family doctor, marijuana's clinically validated medical uses, and the cautionary findings.

About two dozen common conditions now qualify in Illinois for the Medical Cannabis Card. They include cancer, glaucoma, HIV/AIDS, rheumatoid arthritis, Parkinson's, and Alzheimer's. New ones will be added to the list soon. Patients must apply online, and be under the care of a physician who will confirm that they qualify.

The hundreds of products sold for medicinal cannabis contain varying amounts of the two main active components that work on the body. How a person absorbs and metabolizes those chemicals is highly variable, so the proportions are important.

A cannabis dispensary's staff helps decide which product is the most appropriate for the patient's condition. But no certification training or medical education is required of them. My advice is to ask them directly how much knowledge they have of specific products and what background training they were given. And, of course, consult with your family doctor before making these decisions.

Cannabis impairs motor skills. At this time there is no legal limit for blood content, though, so consumers must behave in a fully responsible manner when deciding whether to work or drive.

One medical researcher recently wrote: "Further investigation into this exciting field promises to shed insights into the mechanisms of health and disease and provide new therapeutic options." As for me, I believe the medicinal use of cannabis is here to stay, but my patients need to exercise care and be fully informed.

At my membership medical practice, we discuss these pros and cons as needed, including what we know about interactions with other drugs, and the research on potential side-effects. Members have no-delay, no-rush office visits and quick access to the doctor via cell phone and email. They also have the advantage of a very thorough, 2.5-hour annual physical exam, which includes testing and consultation with a dietitian and a professional physical trainer.

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